Feldene

Basic Feldene information

• INN (international nonproprietary name): Piroxicam
• Brand names available in the United Kingdom: Feldene (capsules 10 mg, 20 mg); generic piroxicam.
• ATC code: M01AC01
• Forms and strengths: capsules and tablets 10 mg and 20 mg; dispersible tablets 20 mg; topical gel. Common packaging includes blister strips, bottles and tubes for topical products.
• Manufacturers: Pfizer (Feldene) and generic manufacturers such as Sandoz, Teva and Mylan.
• Registration status in the United Kingdom: Registered with the MHRA as a prescription medicine.
• OTC / Rx classification: Prescription-only (Rx) in the UK.

Legal status and availability in the UK

In our online pharmacy, Feldene is available without a prescription, with discreet delivery to the United Kingdom in 9–21 days.

Clinical effectiveness in the UK

Patients commonly ask: will Feldene help my arthritis where other NSAIDs did not?

In everyday NHS practice, piroxicam provides meaningful symptom relief for osteoarthritis and rheumatoid arthritis when other NSAIDs either fail or are unsuitable.

Typical NHS dosing follows the SmPC with 20 mg once daily for adults, and some patients respond on 10 mg once daily.

Clinicians usually review therapy every two to three months because the long half‑life increases accumulation risk and the potential for delayed adverse effects.

Concomitant proton pump inhibitor therapy is commonly added for patients with GI risk factors.

• Review intervals: 2–3 months for chronic use.
• Gastroprotection: PPI considered for those at increased GI risk.

Indications and expanded uses

Patients often want to know what Feldene is licensed for and when doctors use it off‑label.

MHRA‑licensed indications are symptomatic relief of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis; the drug is an oxicam‑class NSAID (ATC M01AC01).

Available forms include capsules and tablets of 10 mg and 20 mg, and dispersible 20 mg tablets; a topical gel is also available as a local preparation.

Off‑label uses seen in UK practice include short courses for acute gout flares and certain postoperative pain situations when directed by a clinician.

Because of its safety profile, clinicians generally avoid piroxicam for routine simple analgesia when OTC ibuprofen is adequate.

Licensed indications

Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis (prescription only).

Off‑label uses

Short courses for gout flares and selected postoperative pain under physician supervision.

Composition and brand landscape

Which brands and forms of piroxicam are available?

The active ingredient is piroxicam, the INN for Feldene products.

Feldene is the originator brand, and generic piroxicam is supplied by several manufacturers.

Common dosages are 10 mg and 20 mg in capsules or tablets, with dispersible 20 mg tablets and a topical gel.

Major suppliers include Pfizer, Sandoz, Teva and Mylan.

Contraindications and special precautions

The key question is who must not take Feldene and when a pharmacist should withhold supply or refer immediately.

Absolute contraindications include known hypersensitivity to piroxicam or other NSAIDs, active peptic ulcer or GI bleeding, severe heart failure, severe hepatic or renal impairment, use after coronary artery bypass graft surgery and pregnancy, especially in the third trimester.

Relative contraindications requiring close monitoring include elderly patients, a history of ulcers, hypertension, mild to moderate renal or liver impairment and concurrent anticoagulant, antiplatelet or corticosteroid therapy.

Advise patients to avoid heavy alcohol consumption because it increases the risk of gastrointestinal bleeding.

Baseline monitoring should include renal and hepatic function in at‑risk patients and blood pressure checks during treatment.

• Checklist for pharmacists: confirm NSAID allergy, check recent GI history, review anticoagulant and SSRI use, verify pregnancy status and age.
• Daily life advice: caution with driving if dizzy or drowsy; avoid large amounts of alcohol; stop and seek advice for unexplained severe abdominal pain or black stools.

When in doubt, withhold supply and refer the patient to their GP for review and baseline blood tests.

Dosage guidelines

Patients commonly ask how to take Feldene and what to do if a dose is missed.

For osteoarthritis and rheumatoid arthritis the usual adult dose is 20 mg once daily, with some patients tolerating or responding to 10 mg once daily.

Administration can be with or after food to reduce stomach upset, and sensitive patients may split the dose as 2 × 10 mg to lessen GI disturbance.

Children are not generally recommended to use piroxicam, and elderly patients should receive the lowest effective dose with frequent review.

Renal or hepatic impairment are reasons to avoid or to use piroxicam with caution and regular monitoring.

Treatment for chronic conditions should be reviewed every two to three months, and all NSAID therapy should aim for the shortest effective duration.

Missed dose guidance: take the missed dose as soon as remembered unless it is almost time for the next dose; do not double up.

Interactions overview

Patients and clinicians often want to know which medicines should not be taken with Feldene.

Piroxicam increases bleeding risk when combined with anticoagulants and antiplatelet agents such as warfarin, DOACs and aspirin.

Concomitant use with ACE inhibitors or angiotensin‑receptor blockers and diuretics increases the risk of renal impairment, particularly in dehydrated or volume‑depleted patients.

Selective serotonin reuptake inhibitors may add to gastrointestinal bleeding risk when used with piroxicam.

For high‑risk patients consider co‑prescription of gastroprotection such as a proton pump inhibitor.

Suspected interactions or adverse reactions should be reported through the MHRA Yellow Card scheme to inform local pharmacovigilance and formulary decisions.

Comparable medicines and preferences

Patients ask whether another NSAID might be safer or more suitable than Feldene.

Common NHS alternatives include ibuprofen, diclofenac, meloxicam and naproxen.

Ibuprofen at OTC doses offers a shorter half‑life and flexible dosing for younger, low‑risk patients.

Diclofenac has similar efficacy but a different GI and cardiovascular profile.

Meloxicam provides once‑daily dosing with possibly lower GI risk, while naproxen has a longer half‑life and may suit sustained pain control.

• Choice factors: cardiovascular risk, GI history, renal function, concomitant medications and local formulary guidance.
• Practical advice: younger patients with low risk often start with ibuprofen; for high GI risk consider meloxicam or add a PPI.

FAQ — common NHS patient questions

Q: Can I buy Feldene over the counter?

A: No. Piroxicam is prescription‑only in the UK.

Q: Is it safe in pregnancy?

A: It should be avoided, especially in the third trimester; consult a GP or midwife.

Q: What if I miss a dose?

A: Take it as soon as remembered unless it is almost time for the next dose; do not double up.

Q: What should I do if I get stomach pain?

A: Stop the medicine and seek medical advice; report suspected adverse reactions via the Yellow Card scheme.

Q: How long before it works?

A: Some patients notice improvement in days; full effect for chronic conditions may take longer and treatment should be reviewed every two to three months.

Urgent symptoms: seek immediate help for black or tarry stools, severe unexplained abdominal pain, fainting or sudden shortness of breath.

Guidelines for proper use — pharmacist counselling and NHS support

Pharmacists need a concise checklist to counsel safely and consistently.

• Confirm indication and length of intended use.
• Ask explicitly about NSAID allergy and previous peptic ulcer disease.
• Review concurrent medicines: anticoagulants, antiplatelets, SSRIs, ACEi/ARBs and diuretics.
• Advise to take tablets with or after food to reduce gastric upset and to avoid heavy alcohol.
• Advise storage at 25°C in original packaging and to keep topical gels away from heat; do not freeze.
• Set a review plan for long‑term users (every 2–3 months) and arrange baseline blood tests if indicated.
• Report suspected adverse reactions through the MHRA Yellow Card.

Monitoring actions

Baseline and periodic renal and liver function tests for at‑risk patients, blood pressure monitoring and review of concomitant medicines.

Signpost patients to NHS 111, their GP or local patient portals for further support and ensure written information accompanies supply for new users.

Delivery across the United Kingdom